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ROBERTS   BROTHERS,  Boston. 


In  Foreign  Kitchens. 


W 


ITH  Choice  Recipes  from  England,  France, 
Germany,  Italy,  and  the  North. 


V 


By  HELEN   CAMPBELL, 


A.utlior  of  "  TJie  Easiest  Way  in  IToiiseJceejnng  and  Cooking ," 
'< Pi'isoners  of  Poverty,'*  "The  What-To-Do  Club,"  etc. 


i6mo.    Cloth.    Price,  50  cents. 


While  foreign  cookbooks  are  accessible  to  all  readers  of  foreign 
languages,  and  American  ones  have  borrowed  from  them  for  what  we 
know  as  "  French  cookery,"  it  is  difficult  often  to  judge  the  real  value 
of  a  dish,  or  decide  if  experiment  in  new  directions  is  worth  while. 
The  recipes  in  the  following  chapters,  prepared  originally  for  The 
Epicu7'e,  of  Boston,  were  gathered  slowly,  as  the  author  found  them  in 
use,  and  are  most  of  them  taken  from  family  recipe-books,  as  valued 
abroad  as  at  home.  So  many  requests  have  come  for  them  in  some 
more  convenient  form  than  that  offered  in  the  magazine,  that  their 
present  shape  has  been  determined  upon  ;  and  it  is  hoped  they  may  be 
a  welcome  addition  to  the  housekeeper's  private  store  of  rules  for 
varying  the  monotony  of  the  ordinary  menu. 


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KEEP  YOUR  MOUTH  SHUT. 


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Keep  your  Mouth  Shut. 

gl  'gopular  ^reatijse  on  ^ftotitli-^rcathittg : 

ITS   CAUSES,  EFFECTS,  AND    TREATMENT. 


BY 


FRED.  A.  A.  SMITH,  M.D.,  CM.  Glas., 

M.D.    JEFF.    MED.    COLL.,    L.R.C.P.    EDIN.,    M.R.C.S.   ENG.,    HON.    SURGEON 
CHELTENHAM    (eNG.)   EYE,  EAR,    AND    THROAT   INFIRMARY,    ETC. 


TO    WHICH    IS    ADDED, 

AN   APPENDIX    ON    OPHTHALMIA    IN    NEW-BORN 
CHILDREN, 

By  dr.  smith  AND   DR.  SWAN   M.  BURNETT. 


BOSTON  COLLEGE  LIBRARY 
CHESTNUT  HILL,  MASS. 

BOSTON: 

ROBERTS     BROTHERS, 

1893. 


Copyright,  1893, 
By  Roberts  Brothers. 


155587 


John  Wilson  and  Son,  Cambridge,  U.S.A. 


PEEFACE. 


The  idea  of  writing  this  little  work  was 
first  suggested  to  me  by  having  so  many 
children  brought  for  consultation  who  were 
the  subjects  of  long-standing  and  progres- 
sive disease, — for  the  most  part  susceptible 
to  relief,  but  in  too  many  cases  almost  past 
amelioration,  and  still  more  often  beyond 
cure. 

Mothers  or  others  in  charge  of  them, 
when  told  the  causes  of  their  children's  ail- 
ments, have  almost  invariably  exclaimed : 
"  Why  was  I  not  told  this  before  ?  Had 
I  only  understood  the  case  as  you  put  it, 
I  should  certainly  have  brought  my  child 
years  ago  to  be  properly  treated." 


vi  PREFACE. 

It  is  for  the  purpose  of  showing  parents 
the  danger  of  allowing  the  diseases  treated 
of  in  this  book  to  run  their  course  that  it 
has  been  written.  I  only  hope  and  trust 
that  the  following  pages  may  be  the  means 
of  saving  many  children  yet  to  come.  If 
only  I  could  be  sure  that  even  a  few  would 
be  thus  saved  a  life  of  comparative  misery 
and  uselessness,  I  should  consider  that  I 
had  not  labored  in  vain. 

Portland  House,  Cheltenham, 
August,  1892. 


CONTENTS. 


CHAPTER  PAGE 

I.    Introductory 9 

II.    Mouth-breathing,    and    some     of    its 

Causes 26 

III.  Further  Causes  of  Mouth-breathing     35 

IV.  Effects  .     , 45 

V.     Treatment .48 

Appendix 58 

Prevention  and  Treatment  of  Ophthal- 
mia of  New-born  Infants 64 


MOUTH-BREATHING, 


CHAPTER  I. 

INTEODUCTORY. 

By  supplying  information  and  giving  advice,  I 
desire  to  be  of  real  assistance  to  all  (especially 
to  those  who  are  in  particular  need  of  such  in- 
struction and  aid)  respecting  a  matter  which 
is  most  important  to  the  health  of  the  com- 
munity; namely,  proper  and  improper  meth- 
ods of  breathing,  and  their  bearing  upon 
health  and  disease. 

My  special  experience  in  an  institution  for 
the  separate  treatment  of  diseases  of  the  eye, 
ear,  throat,  and  nose,  has  impressed  upon  me 
the  conviction  that  some  simple,  clear  expla- 
nation of  the  facts  of  the  case,  and  of  the 
true  remedies,  ought  to  be  circulated  most 
extensively  among  the  people ;  so  that  the 
ignorance  which  is  largely  responsible  for  the 
present  sad  state  of  things  may  be  removed. 


10  MOUTH-BREATHING. 

and  that  at  least  it  may  be  possible  for  the 
people  to  act  with  increasing  intelligence  by 
reason  of  knowing  more  than  they  have  ever 
yet  known  respecting  what  they  should  do 
and  what  they  should  avoid. 

The  best  remedies  for  great  ills  in  all  de- 
partments of  life  are  often  amazingly  simple. 
Foolish  people  have  desired  to  be  saved  by 
long  words,  technical  obscurity,  and  mystic 
pretensions ;  whereas  the  true  deliverance  has 
ever  been  through  the  simple,  the  natural,  — 
that  which  is  within  the  grasp  of  all.  So  in 
medicine  and  surgery :  as  we  become  more 
enlightened  we  develop  methods  of  treatment 
which  are  simpler,  more  natural,  more  effec- 
tive than  the  days  of  ignorance  could  possibly 
know. 

A  medical  man  must  take  the  people  into 
his  'confidence,  spread  useful  knowledge,  and 
thus  address  himself  to  the  task  of  elimina- 
ting causes  of  disease  and  disorder,  and  not 
simply  aim  at  the  palliation  or  transference 
of  symptoms. 

I  am  conscious  that  in  this  work  there  is 
much  reiteration,  or  repetition.  This  is  de- 
signed, and  will  have  its  great  utility.     Most 


^  INTRODUCTORY.  11 

persons  are  unable  to  take  anything  in,  — 
especially  any  great  fact  or  truth  which  is 
startling  in  its  simplicity,  —  when  there  has 
simply  been  one  terse,  bold  statement  of  it. 
It  has  to  be  "line  upon  line,  precept  upon 
precept ;  here  a  little,  and  there  a  little." 
The  point  of  view  may  be  changed,  the 
phraseology  may  be  altered,  the  considera- 
tions adduced  in  support  may  be  varied ;  but 
the  thought,  truth,  or  fact  itself  must  be 
repeatedly  presented,  or  it  cannot  possibly  be 
really  received,  —  that  is,  assimilated,  made 
part  of  the  nature,  so  as  to  be  operative  and 
influential  in  the  life  and  conduct. 

The  truth  of  the  above  remark  applies  to 
all  persons,  whatever  the  extent  or  depth  of 
their  culture,  and  is  not  appropriate  merely 
in  the  case  of  the  mass  of  people,  whose  op- 
portunities of  intellectual  cultivation  have 
been  few  and  small,  and  whom  I  now  desire 
specially  to  reach  and  to  influence  for  good. 

The  Healthy  Child  instinctively  breathes 
through  its  Nose.  —  Though  it  is  true  that  the 
new-born  baby,  in  uttering  its  first  cry,  practi- 
cally breathes  through  the  mouth,  yet  it  is  no 
less  true  that  no  sooner  have  its  lungs,  which 


12  MOUTH-BREATniNG. 

had  previously  been  in  a  state  of  collapse, 
become  fully  inflated  than  it  instinctively 
and  persistently  breathes  through  Nature's 
air-passage ;  namely,  the  nose. 

The  Nose  is  the  natural  Breathing-passage. 
It  cannot,  I  think,  be  denied,  or  seriously 
doubted,  that  the  nose  is  the  channel  through 
which  Nature  intends  us  to  breathe,  —  that  is, 
supply  to  the  lungs  the  air  which  they  need 
for  the  due  performance  of  their  important 
functions.  Its  extreme  and  wonderful  sensi- 
tiveness, by  which  it  is  fitted  to  act  as  the 
organ  of  the  sense  of  smell,  enables  it  to 
test  the  air  which  comes  to  it,  and  to  inform 
and  warn  us  respecting  any  impurity  or 
offensiveness  which  may  be  in  the  air.  Its 
structure  shows  its  purpose  and  its  appro- 
priate functional  activity.  One  has  only  to 
study  the  anatomy  of  the  nasal  organ  to  be- 
come convinced  that  it  is  the  breathing  ap- 
paratus destined  and  supplied  by  Nature  for 
our  use. 

Structure  of  the  Nose.  —  On  page  13  we  pre- 
sent a  diagram  of  the  anatomy  of  the  nasal 
fossoB.  These  are  two  in  number,  each  pos- 
sessing two  orifices,  —  the  anterior  nares,  or 


INTRODUCTORY. 


13 


1,  2,  3,  Turbinated  bones. 

4,  Orifice  of  Eustachian  tube. 

5,  Naso-pharyux. 

6,  Soft  palate. 


7,  Pharynx. 

8,  Tonsil. 

9,  Mouth. 
10,  Tongue. 


nostrils ;  and  the  posterior  nares,  opening  into 
the  upper  part  of  the  naso-pharynx.     The  two 


14  MOUTH-BREATHING. 

fossae,  or  cavities,  are  divided  from  each  other 
by  a  vertical  wall,  or  partition ;  their  sides 
are  formed  by  bones  and  the  cartilages  of  the 
nose.  Inside  the  fossae  there  is  a  delicate 
mucous  membrane,  the  extent  of  which  is 
increased  by  folding  over  projections  of  the 
walls  of  the  cavity.  These  projections  are 
spongy  bones,  and  in  man  are  three  in  num- 
ber. Prolongations  of  the  membrane  extend 
into  hollows  of  the  neighboring  bones.  These 
are  called  sinuses  (the  frontal,  above  the  nose 
and  between  the  eyebrows ;  and  the  sphenoi- 
dal, lying  farther  back),  and  the  antrum  of 
highmore  in  the  superior  maxillary  bones. 

One  might  give  a  fuller  description  of  the 
parts,  but  the  above  will  be  sufficient  for  my 
purpose. 

Functions  of  the  Nose.  —  It  has  been,  by 
experiments,  clearly  shown  that  no  matter 
how  cold  the  air  around  us  may  be,  that  air, 
if  allowed  to  filtrate  through  Nature's  orifices 
(the  nasal  passages),  will,  before  reaching 
the  lungs,  be  warmed  to  nearly  the  tempera- 
ture of  the  body.  The  nose  has  not  only  the 
property  of  raising  the  air  (which  is  thus 
filtrated    through    it)    to    that   natural   tem- 


INTRODUCTORY.  15 

perature  of  the  body  which  is  consonant  with 
health,  but  it  has  also  the  functional  duty  of 
doing  that  which  can  be  accomplished  by  no 
other  organ;  namely,  intercepting  the  pass- 
age of  all  those  germs  (impurities,  etc.)  which 
are  floating  in  the  atmosphere,  and  are  detri- 
mental to  the  human  body.  This  very  fact 
that  the  passage  of  air  through  the  nose  is 
sufficient  to  raise  it  to  the  temperature  of 
the  body,  is  enough  of  itself,  without  any 
further  reasoning,  to  prove  that  this  is  the 
natural  method  of  breathing. 

What  do  we  see  in  a  baby  after  the  first 
preliminary  effort  of  crying,  by  which  the 
little  stranger  shows  that  it  is  (and  we  hope 
will  remain)  a  human  inhabitant  of  this  fair 
world  ?  We  see  that  although  prior  to  birth 
its  lungs  were  in  a  condition  of  collapse,  it 
has  inflated  them  by  a  process  which  I  own 
is  tantamount  to  mouth-breathing;  but  we 
also  see  that  from  the  moment  of  the  com- 
pletion of  that  necessary  process  of  inflation 
it  instinctively  and  persistently  refuses  to  use 
its  mouth  at  all  for  the  purpose  of  breathing, 
but  employs  in  preference  Nature's  air-pas- 
sage,—  the  nose. 


16  MOUTH-BREATHING. 

Mouth-breathing  a  Danger-signal.  —  As  SOOn 
as  a  child  refuses  to  breathe  through  its 
nose  something  is  wrong ;  and  then  it  is  that 
the  mother,  who  is  supposed  to  care  for 
and  tend  her  offspring,  should  hnow  that 
something  is  wrong,  and  should  seek  for  a 
remedy. 

"What  the  Mother  should  do.  — The  evil  is 
not  that  mothers  are  guilty  of  wilful  wrong- 
doing, but  that  they  are  ignorant  of  what 
should  be  done,  what  is  right  to  do,  and  what 
they  should  avoid  doing.  They  are  very 
much  to  blame  when  they  do  not  seek  proper 
advice  as  soon  as  anything  connected  with 
the  child  is  evidently  out  of  order.  When  a 
mother,  or  other  person  in  charge  of  a  child, 
is  told  clearly  and  plainly  what  ought  to  be 
done,  she  will  certainly  be  blameworthy  ,if  she 
does  not  do  it ;  and  much  harm  may  come  to 
the  child  if  such  directions  be  not  obeyed. 

The  Coming  Race.  —  I  must  say  a  word 
respecting  an  important  point  upon  which 
plain-speaking,  although  it  might  be  very 
beneficial,  is  by  no  means  as  common  as  it 
ought  to  be.  The  propagation  of  offspring 
should  never  be  to  human  beings  the  aimless, 


INTRODUCTORY.  17 

thoughtless,  or  selfish  indulgence  of  passion, 
or  the  mere  reproduction  or  perpetuation  of 
their  personal  selves ;  but  it  should  be  re- 
garded as  the  natural  and  divine  method  of 
the  continuance  of  the  human  race ;  and  the 
aim  should  be  to  rear  a  generation  which  shall 
surpass  that  which  has  preceded  it,  and  be  an 
honor  to  its  species. 

The  backbone  of  a  nation  is  really  the 
working-classes  ;  and  it  is  they  who  should  be 
taught  to  understand  and  recognize  disease  in 
its  first  stages,  and  be  enabled  by  proper  in- 
struction to  stamp  it  out,  and  rear  their  chil- 
dren to  become  healthy  and  robust  adults. 
When  we  have  passed  away  from  the  stage 
of  bodily  life,  we  should  leave  behind  us  an 
improved  race,  instead  of  one  which  is  deteri- 
orated ;  and  this  great  end  can  be  attained 
only  by  stamping  out  disease  in  its  earlier 
manifestations,  even  in  its  beginnings,  by 
avoiding  the  causes  of  disorder,  by  obedience 
to  the  laws  of  health  and  the  laws  of  the 
human  body  and  mind,  and  by  thus  rearing 
up  children  who  shall  be  strong  and  healthy 
both  in  constitution  and  in  life. 

From  this  point  of  view,  and  with  reference 


18  MOUTH-BREATHING. 

to  my  special  theme,  it  must  be  earnestly  said 
that  all  which  human  beings  can  do  should 
be  carefully  done  to  avoid  the  introduction 
into  the  world  of  children  who  are  blind, 
lame,  or  deaf,  or  have  even  only  some  im- 
pediment of  speech.  What  the  world  really 
needs  is  a  race  of  men  and  women  fully  pos- 
sessed of  all  the  powers  which  are  naturally 
their  heritage  and  endowment,  and  who  are 
capable  of  holding  their  own  in  the  country 
to  which  they  belong,  enduring  the  strain  of 
life  and  performing  its  duties. 

Troubles  arising  from  the  Ignorance  of  Mid- 
wives.  —  The  troubles  that  have  accrued  to 
humanity  from  the  ignorance  of  midwives  — 
I  will  not  say  from  their  wilful  or  assumed 
ignorance,  or  their  conscious  wrong-doing  — 
are  to  my  mind  innumerable,  unspeakable, 
intolerable.  This  remark  is  not  simply  theo- 
retical ;  it  is  also  practical,  and  arises  from 
my  own  experience.  When  I  find  that  thou- 
sands of  children  who  are  born  healthy  and 
well  are,  through  the  ignorance  of  these 
women,  allowed  to  become  practically  blind, 
it  becomes  to  me  an  intolerable  scandal.  Case 
after  case  comes  before  me  in  which  it  has 


INTRODUCTORY.  19 

to  be  said  that  the  poor  child  is  practically 
beyond  medical  skill.  The  mother  will  tell 
me  that  there  was  nothing  the  matter  with  it 
except  a  cold  in  the  eye ;  and  yet  when  it  is 
at  last  brought  for  treatment,  it  is  often  ex- 
tremely difficult  to  save  what  little  sight  has 
not  been  irremediably  injured.  It  is  the  same 
with  other  diseases. 

The  important  point  I  wish  to  enforce  is 
this,  —  that  mothers  and  midwives  (and  what 
I  am  writing  is  chiefly  for  mothers  and  oth- 
ers in  charge  of  the  young,  and  not  for  the 
medical  profession,  the  members  of  which 
know  already  all  about  it)  should  be  taught 
what  they  ought  to  do  on  behalf  of  those  for 
whose  birth  and  subsequent  welfare  they  are 
responsible. 

Mouth-Breathing  a  sign  of  Obstruction.  —  It 
is,  I  repeat,  quite  clear  that  the  nose  is  the 
only  proper  channel  through  which  we  should 
respire.  So  soon  as  a  child  begins  to  breathe 
through  its  mouth,  something  is  wrong ;  there 
is  some  difficulty,  some  obstruction,  some  dis- 
order, and  it  is  time  for  the  mother  to  be 
watchful  and  careful,  and  to  obtain  advice  as 
to  why  her  little  one  does  not  breathe  in  the 


20  MOUTH-BREATHLNG. 

manner  intended  bj  Nature,  —  high  time  to 
obtain  and  apply  the  remedy  for  the  obstruc- 
tion or  difficulty,  whatever  it  may  be. 

When  the  child  begins  to  breathe  through 
other  channels  than  those  which  Nature  or- 
dained, something,  I  repeat,  is  wrong;  and 
the  sooner  the  obstacle  is  discovered  and  the 
remedy  applied,  the  better  it  will  be  for  the 
child. 

I  lay  great  and  repeated  stress  upon  these 
preliminary  facts  for  the  simple  reason  that 
I  believe  that  it  is  not  through  wilful  neglect 
or  criminal  cruelty,  but  through  pure  igno- 
rance, that  so  many  children  are  ruined  for 
life.  How  sad  it  is  to  see  a  poor  child,  who 
had  it  received  proper  attention  and  care  dur- 
ing infancy  might  have  been  perfectly  healthy, 
now,  for  lack  of  these,  walking  about  blind, 
deaf,  dumb,  or  lame !  And  our  sadness  is  no 
way  lessened  when  we  think  that  it  might 
have  been  cured  had  it  been  taken  to  a  man 
who  clearly  understood  what  was  the  matter, 
and  how  to  treat  the  case ! 

I  am  glad  to  say  that  many  of  us  are 
neither  lame,  blind,  nor  dumb ;  but  I  some- 
times wonder  what  we  might  have  been  had 


INTRODUCTORY.  21 

"we  been  left  to  the  aid  of  Nature  alone,  with- 
out human  care,  watchful  kindness,  and  skill. 
Nature,  no  doubt,  is  the  great  healer,  and 
true  medical  science  must  be  a  lowly,  obe- 
dient student  of  Nature.  No  one  believes  in 
Nature  more  devoutly  and  completely  than  I 
do.  But  what  is  our  position  in  Nature,  and 
for  what  purpose  are  we  created  and  placed 
here  ?  We  are  here,  not  to  oppose  and  defy 
Nature,  but  to  aid  her  and  obey  her.  And 
although  medical  science  is  far  below  that 
point  of  excellence  which  I  could  wish  it  had 
reached, —  far  beneath  the  position  of  knowl- 
edge and  skill  which  it  ought  to  occupy,  —  it 
is  yet  the  great  and  beneficial  healing  art; 
and  it  can,  to  a  very  great  extent,  aid  Nature 
and  bless  mankind.  He  is  the  most  success- 
ful doctor  who  does  not  oppose  Nature,  but 
endeavors  to  co-operate  with  her.  When  we 
are  trying  to  alleviate  suffering,  we  must  re- 
member that  so  far  as  human  beings  are  con- 
cerned we  must  work  in  harmony  with  Nature, 
or  we  cannot  possibly  be  successful. 

Take  Advice  in  Time.  — Those  in  charge  of 
children  should  realize  that  cases  ought  to 
be  treated  by  competent  medical  men  before 


22  MOUTH-BREATHING. 

they  are  too  far  gone  to  be  cured.  Neglect 
may  be  innocent  and  unconscious,  while  it  is 
at  the  same  time  most  lamentable  and  disas- 
trous; or  it  may  be  wilful,  obstinate  unreason, 
and  thus  criminal  and  guilty.  Ignorance  is  to 
be  pitied  and  removed;  wilful  folly  must  be 
corrected  and  overruled. 

Did  mothers  know  more  fully  what  really 
should  be  done,  they  would  not,  I  am  per- 
suaded, act  as  they  now  so  often  do.  I  can- 
not imagine  a  mother  knowingly  permitting 
her  child  to  become  blind  or  deaf  or  lame,  and 
thus  imperfectly  developed,  or  a  sufferer  for 
life.  Women  are  naturally  good  at  heart ; 
they  simply  lack  and  need  knowledge  of  what 
to  do.  However  ignorant  the  mother  may 
be,  if  she  were  told  the  real  facts  of  the  case, 
and  that  such  and  such  consequences  must 
ensue  from  a  given  state  of  things  or  a  cer- 
tain course  of  conduct,  she  would  not  for  a 
moment,  I  think,  allow  her  child  to  become 
hopelessly  maimed  or  disordered,  or  to  suffer 
through  her  neglect.  She  must  be  a  very 
bad  and  very  vile  woman  indeed  who  would 
consciously  and  wilfully  allow  her  child  to 
incur  a  disease,  or  to  be  practically  deprived 


INTRODUCTOKY.  23 

of  a  sense  or  a  faculty,  when  she  herself 
has  the  power  and  knowledge  to  avoid  such 
sad  results.  But  apart  from  any  possible 
and  actual  exceptions,  I  am  convinced  that 
ignorance  —  sheer,  crass  ignorance  —  occa- 
sions the  careless  or  wrong  treatment  dur- 
ing infancy  which  is  the  cause  of  so  much 
of  the  suffering  entailed  upon  mortals  in 
after-life. 

I  do  not  pose  as  a  prophet  or  miracle- 
worker.  I  simply  desire  and  intend,  in  com- 
mon humanity,  to  do  what  I  possibly  can  on 
behalf  of  those  who  come  after  me,  and  who, 
I  trust,  may  avoid  the  remediable  and  remov- 
able suffering  which  has  already  too  long 
afflicted  the  human  race.  I  have  written,  I 
trust,  quite  sufficient  —  with,  as  I  have  ex- 
plained, designed  reiteration  —  to  render  my 
main  point  perfectly  clear. 

The  reader  has  only  to  look  back  to  the 
diagram  which  I  have  given  to  see  exactly 
the  anatomy  and  structure  of  the  nose.  If 
beauty  means  harmony  of  structure  and  form, 
in  view  of  functional  activity  to  be  manifested 
and  environment  to  be  inhabited  and  adapted, 
then  I  would   say  that   in   human  anatomy 


24  MOUTH-BREATHING. 

there  is  no  organ  more  beautiful  in  structure 
than  the  nose. 

If  the  reader  will  examine  its  structure,  he 
will  see  that  there  are  spongy  bones  covered 
with  erectile  tissue,  which  fills  or  empties,  is 
expanded  or  contracted,  according  to  require- 
ments in  the  process  of  respiration. 

The  nose,  then,  is  Nature's  respirator. 
Whatever  may  be  the  temperature  of  the 
atmospheric  air  as  we  leave  our  home,  we 
shall  find  that  so  long  as  we  keep  our  mouth 
shut  the  nose  will  warm  the  air  respired  to 
nearly  the  temperature  of  the  body  before 
such  air  reaches  the  lungs. 

The  absolute  Sovereignty  of  Nature.  - —  So 
soon  as  we  begin  to  play  fast  and  loose  with 
Nature,  or  to  act  arbitrarily  in  fancied  ability 
to  defy  her  dictates,  so  soon  will  Nature's 
penalties  be  enforced  against  us.  I  lay  it 
down  as  a  law  that  Nature  is  paramount  and 
obligatory.  If  we  obey  her,  we  obtain  and 
enjoy  the  blessing  which  attends  docility 
and  harmony;  but  if  we  defy  and  disobey 
her,  we  do  so  to  our  own  loss,  pain,  and  woe. 
He  who  fulfils  Nature's  behests  will  naturally 
succeed  better  in  life  than  can  he  who  per- 


INTRODUCTORY.  25 

sistently  and  madly  breaks  his  bones  on  the 
wheel  of  necessity  by  opposing  his  puny  self 
to  Nature's  laws,  which  he  cannot  alter,  and 
the  operation  of  which  he  cannot  escape. 
Many  misled  by  ignorance  or  prejudice,  or 
false  assurance,  have  no  idea  that  there  are 
laws  of  Nature ;  and  it  all  seems  to  them  an 
arbitrary,  chaotic,  inscrutable  affair.  Really, 
however,  there  are  laws  of  Nature ;  and 
those  laws  are  wise  and  good,  and  cannot 
be  broken  with  impunity. 

*'  Though  the  mills  of  God  grind  slowly, 

Yet  they  grind  exceeding  small  ; 
Though  with  patience  He  stands  waiting, 
With  exactness  grinds  He  all." 

If  this  little  work  be  the  means  of  enlight- 
ening, warning,  or  guiding  any  persons,  and 
thus  of  doing  any  good  to  suffering  human- 
ity, I  shall  be  much  gratified,  and  shall  feel 
myself  fully  rewarded. 


CHAPTER  II. 

MOUTH-BREATHING,   AND   SOME   OF   ITS   CAUSES. 

The  Nose  is  the  only  natural  Breathing-pass- 
age. —  When  a  child  begins  to  breathe  other- 
wise than  through  Nature's  channels,  it  is  in 
danger ;  and  she  is  a  wise  and  good  mother  who 
will  at  once  endeavor  to  find  out  the  cause  and 
the  remedy.  The  instinct  to  breathe  through 
the  nose  is  so  strong  as  to  be  apparent  to  the 
most  casual  observation.  Who  ever  saw  a 
man,  woman,  or  child  in  a  state  of  nature  — 
I  mean  in  a  savage  state  —  breathing  through 
the  mouth  ?  I  have  travelled  in  all  parts  of 
the  world,  and  never  saw  among  savages 
more  than  one  mouth-breather ;  and  he,  by 
coming  into  contact  with  "  civilizing  "  influ- 
ences, had  become  so  addicted  to  the  habit  of 
taking  intoxicating  liquors  that  he  appeared 
to  be  compelled  to  breathe  through  the  mouth 
as  the  largest  opening.     Catlin  says :    ''  If  I 


SOME   OF  ITS   CAUSES.  27 

were  to  endeavor  to  bequeath  to  posterity  the 
most  important  motto  which  human  knowl- 
edge can  convey,  it  should  be  in  three  words  : 
'  Shut  your  mouth  ! '  "  Catlin  also  says  that  he 
found  among  two  millions  of  people  living 
in  a  savage  state  only  three  or  four  deaf- 
mutes,  and  not  another  individual  who  was 
hard  of  hearing.  Savages,  in  fact,  never 
breathe  through  the  mouth.  Animals,  also, 
when  quiet,  breathe  only  through  the  nose. 
It  is  true  that  some  animals  pant,  and  when 
so  doing  breathe  through  the  mouth ;  but 
that  is  only  when  they  are  out  of  breath 
through  excessive  exertion,  or  under  condi- 
tions of  intense  heat.  As  soon  as  they  become 
quiet,  calm,  and  cool,  they  resume  natural 
breathing,  —  that  is,  through  the  nose. 

Nature  asserts  herself  everywhere.  She 
lays  down  certain  laws.  If  we  fulfil  those 
laws,  things  go  well  with  us ;  if  we  neglect 
them,  we  suffer.  In  the  long-run  we  shall 
find  that  the  Great  Architect  of  the  universe 
will  assert  himself,  and  will  prove  to  us 
that  he  is  master,  and  that  his  laws  are  to 
be  obeyed.  We  may  depend  upon  it,  that 
his  arrangements  are  for  the  best. 


28  MOUTH-BREATHING. 

Thus,  Nature  having  given  a  certain  pass- 
age through  which  we  are  to  breathe,  the 
person  who  does  not  use  that  passage,  or  who 
does  not  employ  it  exclusively,  will  certainly 
in  the  long-run  suffer. 

Importance  of  Promptitude.  —  On  the  first 
intimation  that  the  breathing  of  an  infant  is 
performed  through  the  mouth,  the  mother 
should,  I  repeat,  endeavor  to  find  out  the 
cause  of  such  deviation  from  the  natural  rule, 
and  seek  special  advice  and  aid;  and  she 
will  be  guilty  of  absolute  cruelty,  as  well  as 
of  reprehensible  neglect,  if  she  fail  thus  to 
investigate  the  cause  of  disorder,  and  to  take 
and  act  upon  the  advice  which  may  save 
the  child  untold  misery  in  its  after-life. 

It  is  heart-rending  to  see  men  and  women 
suffering  from  diseases  which,  with  very  little 
trouble,  might  have  been  arrested  and  cured 
in  their  early  stages.  Look  at  our  work- 
houses, our  asylums,  our  hospitals.  How 
many  of  our  fellow-creatures  at  present  suf- 
fering in  these  institutions  might  have  been 
saved  from  that  which  they  now  endure  had 
they  been  properly  treated  at  the  outset ! 
Take  disease  in  its  first  stage,  and  it  is  easily 


SOME  OF  ITS  CAUSES.  29 

and  speedily  cured;  but  begin  only  after  a 
time  of  delay  to  pay  attention  to  it,  and  it 
has  then  become  difficult  and  almost  impossi- 
ble to  effect  a  cure. 

I  have  often  wished  that  it  lay  in  my  power 
to  relieve  the  misery  caused  by  that  neglect 
which  is  visible  daily  in  our  towns  and  vil- 
lages. Personally,  I  have  little  or  no  reason 
to  complain  of  neglect :  Nature  has  been  kind 
to  me.  But  I  desire  to  be  of  some  service  to 
my  fellow-creatures;  accordingly,  with  re- 
peated request  and  earnest  plea,  I  urge  them 
to  seek  relief  and  cure  while  yet  there  is  time ; 
for  there  is  "  no  time  like  the  present." 

Causes  of  Mouth-breathing.  —  The  causes  of 
mouth-breathing  are  numerous ;  in  fact,  de- 
tailed reference  to  them  all  would  involve 
the  composition  of  a  far  larger  book  than  it 
is  my  intention  to  produce  at  present. 

"  Cold  in  the  Head."  —  In  the  first  place, 
taking  the  new-born  baby  as  an  example,  it  is 
well  known  that  a  few  days  after  birth  the 
child  (generally  through  hereditary  disease) 
has  what  is  commonly  known  as  "  cold  in  the 
head."  Of  course,  this  ought  to  be  attended 
to  by  the  medical  man,  and  treated  profes- 


30  MOUTH-BREATHING. 

sionally.  She  is  a  wise  woman  who  "  takes 
time  by  the  forelock,"  and  does  not  by  neglect 
and  delay  allow  the  child  to  lapse  into  a  state 
of  chronic  disease. 

Sleeping  on  One  Side  only.  —  Another  cause 
of  mouth-breathing  is  the  habit  of  allowing  a 
child  to  sleep  on  one  side  only.  I  lay  great 
emphasis  upon  this  point ;  for  I  am  sure  that 
if  a  child  persistently  lies  on  one  side,  the 
filling  up  of  the  erectile  tissue  of  the  nostril 
situated  nearest  the  pillow  will  produce  the 
very  disease  which  afterwards  develops  into 
obstruction  of  that  nostril. 

Deviation  of  the  Septum.  - —  It  is  my  firm 
conviction  that  such  apparently  simple  and 
trifling  matters  are  the  cause  of  many  devia- 
tions of  the  septum  (partition  between  the 
right  and  left  nasal  cavities).  It  is  well  to 
realize  what  this  means  and  involves.  In 
case  of  a  person  afflicted  with  deviation  of 
the  septum,  with  a  tendency  to  hypertrophy 
(excessive  enlargement)  of  the  spongy  bones, 
the  greater  the  quantity  of  air  breathed  in, 
the  more  serious  does  the  closure  of  the  nos- 
tril become,  owing  to  the  ala  of  that  side 
acting  as  a  valve. 


SOME  OF  ITS  CAUSES.  31 

Spurs,  Enchondromas,  etc. —  Spurs,  enchon- 
dromas  (cartilaginous  tumors)  and  other  ob- 
structions are,  no  doubt,  frequently  productive 
of  mouth-breathing.  But,  in  my  opinion, 
nearly  all  these  cases  could  be  relieved  and 
cured  if  taken  in  time. 

The  Fallacy  of  letting  "  Well  enough  "  alone. 
I  am  now  writing  not  so  much  for  those  who 
have  attained  adult  age,  as  for  the  purpose 
of  warning  parents  and  others  who  have 
charge  of  young  children  against  the  evils  of 
leaving  what  is  often  termed  "  well  enough  " 
alone.  I  know,  by  observation  and  experi- 
ence, the  evil  effects  of  "  letting  well  enough 
alone ; "  but  if  something  is  wrong,  we  should 
at  once  seek  for  alleviation  and  cure.  "  De- 
lays are  dangerous."  When,  for  instance,  a 
child  is  suffering  from  discharge  at  the  ear, 
it  seems  careless  and  criminal  —  it  is  assur- 
edly very  dangerous  —  for  any  one,  whether 
a  medical  man  or  one  of  the  laity,  to  tell 
people  to  "  leave  well  enough  alone."  It  is 
much  wiser  to  say :  "  Here  is  something 
wrong,  —  a  disorder,  an  evil ;  we  must  ear- 
nestly endeavor  to  alleviate  and  cure  it." 

I  shall  further  on  point  out  the  great  danger 


32  MOUTH-BREATHING. 

of  discharge  at  the  ear.  I  am  now  simply 
endeavoring  to  impress  upon  the  minds  of  my 
readers  the  great  importance  of  never  allow- 
ing respiration  otherwise  than  as  Nature  has 
ordained  to  continue  unchecked  after  the  first 
symptom. 

There  are  many  other  causes  why  nasal 
respiration  does  not  take  place.  I  mentioned 
just  now  that  a  primary  cause  is  coryza,  or 
cold  in  the  head.  This  may  be  specific,  or 
it  may  be  idiopathic ;  but  whatever  be  its  na- 
ture, it  should  never  be  allowed  to  continue. 
So  soon  as  her  child  begins  to  breathe  oth- 
erwise than  through  Nature's  organ,  the 
mother  should  endeavor  at  once  to  discover 
the  cause  and  to  obtain  advice  and  remedy. 

Result  of  continued  Colds  in  the  Head.  —  If 
this  coryza  be  allowed  to  continue,  it  will,  no 
doubt,  occasion  difficulty  of  breathing  through 
the  nasal  channel,  and  it  may  further  result 
in  growths  which  eventually  lead  to  complete 
obstruction. 

When  a  child  ceases  to  breathe  through 
its  natural  organ,  what  happens  ?  It  must 
breathe  in  order  to  live ;  and  if  Nature  be 
thwarted  in  her  endeavor  to  utilize  the  proper 


SOME  OF  ITS  CAUSES.  33 

channel,  she  goes  immediately  to  that  which 
lies  nearest,  —  that  is,  the  mouth,  —  and  per- 
force uses  that.     What  is  the  consequence  ? 

Immediate  results  of  Mouth-breathing.  —  The 
cold,  damp  air  of  our  climate,  which  passing 
through  the  natural  channels  would  have 
been  properly  ventilated,  warmed,  and  ap- 
proximated to  the  temperature  of  the  body, 
is  taken  in  first-hand,  and  allowed  to  fill  the 
lungs  while  in  a  crude,  unmodified  state.  The 
first  symptom  we  note  is  that  the  child  has  a 
sore-throat.  Those  in  attendance  may  call 
it  anything  they  like,  but  the  fact  remains 
the  same. 

Something  is  wrong.  The  child  cannot 
breathe  properly.  It  consequently  tries  to 
breathe  through  its  mouth ;  and  it  will  be 
lucky  if  it  escape  with  only  enlargement  of 
the  tonsils.  But,  as  a  rule,  the  longer  it  is 
allowed  to  breathe  in  that  way  the  larger  will 
the  tonsils  become,  the  more  the  nose  will 
be  blocked,  and  the  more  miserable  the  child 
will  feel. 

After-effects  of  Mouth-breathing.  —  The  after- 
effects are  cruel  and  dreadful.  Nearly  all 
our  cases    of    asthma,     chronic    bronchitis, 

3 


84  MOUTH-BREATHING. 

winter  cough,  narrow  chests,  pigeon  breasts, 
and  consumption,  forming  a  very  large  part 
of  the  physical  sufferings  under  which  human 
beings  are  groaning  to-day,  might  be  traced 
to  that  one  dereliction  against  which  I  am 
so  anxious  repeatedly  to  warn  every  one, — 
namely,  the  neglect  of  breathing  through  the 
natural  channel. 

The  main  reason  why  so  many  persons  are 
at  this  moment  dwarfed,  deformed,  or  imper- 
fectly developed,  is  that  in  their  youth  these 
things  which  I  so  eagerly  desire  to  impress 
upon  my  readers  were  unfortunately  not  un- 
derstood. Hence  proceed  our  manifold  woes. 
If,  through  my  earnest  iteration  of  truth,  my 
readers  will  understand  and  realize  that  their 
diseases  and  deformities  are  not  an  absolute, 
unavoidable  decree  of  mystic,  awful  fate,  but 
that  they  are  remediable  and  removable,  and 
that  it  is  our  duty  to  alleviate  and  to  cure 
them,  then  the  way  will  be  opened  more  widely 
for  human  progress  and  improvement.  And 
rich  benediction  will  then  result  to  beings 
yet  unborn,  from  our  co-operation  with  true 
science,  and  our  determined  endeavor  to  un- 
derstand and  obey  the  laws  of  health. 


CHAPTER  III. 

FURTHER   CAUSES   OF  MOUTH-BREATHING. 

Hereditary  Tendencies  and  Diseases.  —  It  is 
sad  to  think  how  many  children  are  handi- 
capped from  their  birth  upwards,  owing  not 
only  to  bad  hereditary  tendencies,  but  also  to 
hereditary  diseases,  the  germs  of  which  are 
more  or  less  always  present,  though  often 
only  latent. 

Scrofula  and  Syphilis  one  and  the  same.  — 
That  scrofula  and  syphilis  have  a  great  deal 
to  do  with  diseases  of  the  nose,  most  physi- 
cians will,  I  think,  acknowledge.  The  late 
Professor  Gross,  in  one  of  his  able  lectures  at 
which  I  was  present,  said :  "  If  the  Almighty 
will  but  spare  me  a  few  years  longer,  I  will 
prove  conclusively  that  these  two  diseases  are 
one  and  the  same,  though  in  a  different  de- 
gree." The  prevalence  of  these  diseases,  espe- 
cially among  our  poorer  classes,  is  very  great ; 
and  although  any  part  of  the  body  may  be 


36  MOUTH-BEEATHING. 

attacked  by  them,  it  is,  in  my  opinion,  the 
nose  which  generally  first  shows  more  or  less 
of  their  ill  effects. 

Rheumatism  and  Gout  causes  of  Disease  of  the 
Nose.  —  It  is,  however,  not  so  generally  under- 
stood or  admitted  that  rheumatism  and  gout 
are  also  primary  causes  of  many  diseases  of 
the  nose.  How  frequently  it  occurs  that  a 
plump-looking  and  to  all  appearance  perfectly 
healthy  child  develops  later  a  disease  of  the 
nose,  taking  that  form  popularly  known  as 
"  snuffles,"  —  this  being  generally  due  to 
syphilis !  Rheumatism,  on  the  other  hand, 
does  not  attack  children  so  early  ;  but  sooner 
or  later  many  of  them,  inheriting  the  poison 
of  this  disease,  develop  a  tendency  to  those 
"  colds  in  the  head  "  which  are  due  to  it. 

Effects  of  an  ordinary  Cold  in  the  Head.  — 
That  many  diseases  of  the  respiratory  organs 
commence  in  the  nose  there  is,  I  think,  no 
doubt.  What  is  the  effect  of  an  ordinary 
cold  in  the  head  (or  nose)  of  a  child  ?  Clearly 
in  the  first  place  the  nasal  fossas  become  con- 
gested and  hypersemic  (excessive  accumula- 
tion of  blood)  ;  in  the  second  place  a  larger 
amount  of  mucus  is  secreted  than  is  natural, 


FURTHER  CAUSES.  37 

and  the  child  becomes  unable  to  breathe 
through  Nature's  passage,  the  nose.  This 
symptom,  after  remaining  a  few  days,  may 
disappear  and  apparently  leave  no  ill  effects 
behind ;  but  before  very  long  the  child,  either 
from  being  placed  in  a  draught,  kept  out  too 
late  at  night,  or  in  an  atmosphere  unsuited  to 
its  constitution,  develops  another  and  perhaps 
severer  attack. 

Organic  Disease  of  the  Nasal  Fossae.  —  No 
sooner  are  these  attacks  developed  one  after 
another,  than  the  child  will  of  a  surety  have 
an  organic  disease  of  the  nasal  fossae. 

Mouth-breathing. — Unable  to  breathe  through 
its  nose,  it  does  the  next  best  thing  for  its 
own  comfort,  and  begins  to  breathe  through 
its  mouth. 

Hypertrophy  causes  Formation  of  Adenoid 
Growths.  —  Little  or  no  air  then  passing 
through  the  nostrils  reaches  the  nasal  fossse, 
and  the  consequence  is  that  the  mucous  mem- 
brane of  the  back  of  the  nose  participates  in 
the  congestion  or  hypersemia  of  the  nasal 
fossae,  and  sooner  or  later  hypertrophy  (ex. 
cessive  enlargement),  taking  as  a  rule  the 
form  of  adenoid  (glandular)  growths,  is  de- 


38  MOUTH-BREATHING. 

veloped,  —  these  growths  thriving  best  in  a 
situation  devoid  of  proper  ventilation. 

Congestion  or  Hyperaemia  of  Pharynx.  —  The 
next  stage  (the  child  having  developed  a  pro- 
pensity for  breathing  through  its  mouth)  is 
that  the  air  taken  in  a  crude  state  without 
the  intervention  of  Nature's  true  respirator, 
especially  the  air  respired  at  night,  develops 
congestion  or  hy perse mia  of  the  pharynx. 

Chronic  Sore-throat.  —  Should  this  be  al- 
lowed to  go  on,  the  child  in  most  cases  be- 
comes the  subject  of  what  may  be  called 
chronic  sore-throat,  —  not  always  sore  in  the 
sense  of  pain  being  developed,  but  that  on 
examination  the  pharynx  will  be  found  to  be 
red  and  more  or  less  inflamed. 

Enlargement  of  Tonsils.  —  The  tonsils  will  in 
many  cases  enlarge ;  and  we  have  now  a  men- 
tal picture  of  what  is  most  commonly  seen,  — 
a  child  unable  to  breathe  through  its  nose, 
suffering  from  growths  in  the  naso-pharynx 
and  enlargement  of  the  tonsils;  also  hyper- 
trophy, more  or  less,  of  the  mucous  membrane 
of  the  pharynx. 

These  cases  one  sees  by  the  hundred ;  and 
the  cause  of  most  of  them  is,  in  my  opinion, 


FURTHER   CAUSES.  39 

to  be  found  in  an  hereditary  tendency  to 
rheumatism  or  gout. 

Diphtheria,  Scarlet  Fever_,  Measles^  etc.  — 
Other  causes  of  mouth-breathing  in  children 
may  be  mentioned.  For  example ;  a  child 
gets  diphtheria,  scarlet  fever,  measles,  or  some 
of  the  many  other  specific  diseases  which 
generally  produce  more  or  less  acute  inflam- 
mation of  the  throat,  especially  the  pharynx, 
developing  by  this  inflammation  chronic  hy- 
pertrophy both  of  the  nasal  and  the  sur- 
rounding mucous  membranes. 

Recurrent  Attacks  of  Sore-throat.  —  Then, 
again,  it  is  no  uncommon  thing  to  find  chil- 
dren (and  for  that  matter  adults  also)  suffer- 
ing from  recurrent  attacks  of  sore-throat, 
owing  to  bad  air  and  bad  surroundings,  — 
practically  from  the  same  causes  as  those 
producing  scarlet  fever,  etc. 

Excess  of  MucHs  a  Cause.  —  Another  cause 
may  be  found  in  children  who,  although  not 
suffering  exactly  from  so-called  "  colds  in  the 
head,"  secrete  in  their  nasal  foss^  an  un- 
natural amount  of  mucus,  which,  by  becom- 
ing inspissated  (thickened),  tends  to  block 
up  the  passages,  and  thus  causes  the  child 
to  breathe  more  or  less  througli  its  mouth. 


40  MOUTH-BREATHING. 

Accidental  Causes.  —  That  little  children 
are  very  prone  to  tumbling  about  and  hurting 
themselves  goes  without  saying.  In  those 
cases  where  the  unfortunate  child  happens  to 
fall  on  its  nose,  a  certain  amount  of  local 
inflammation  is  produced,  and  in  many  cases 
a  deviation  from  the  middle  line  of  the  sep- 
tum, —  producing  a  state  of  things  which,  by 
developing  congestion  of  the  turbinated  bones 
and  their  mucous  covering,  causes  a  hyper- 
aemic  condition  of  the  bony  or  cartilaginous 
septum,  often  producing  local  hypertrophy, 
spurs,  and  enchondromas.  That  spurs  and 
enchondromas  are  more  or  less  thus  caused 
primarily  by  injuries  to  the  nose  during 
childhood,  I  have  not  the  slightest  doubt. 
No  one  can  injure  any  part  without  produc- 
ing, primarily,  inflammatory  action ;  second- 
arily, hypertrophy.  In  the  case  of  a  child 
which  has  fallen  on  its  nose,  and  the  carti- 
lage of  the  septum  is  struck  on  one  side,  not 
necessarily  broken,  but  bent,  —  what  is  the 
result  ?  The  whole  of  the  nose  on  the  side 
towards  the  bend  will,  every  time  the  child 
tries  to  breathe  through  that  nostril,  tend  to 
move  towards  the  middle  line,  acting  thus  as 


FURTHER  CAUSES.  41 

a  valve.  The  side  opposite  becoming  from 
this  deviation  more  patent  than  natural,  the 
mucous  membrane  and  the  turbinated  bones 
of  that  side  tend  in  all  cases  to  become  en- 
larged and  to  grow  toward  the  septum,  as 
though  thej  were  afraid  of  being  left  in  the 
lurch,  —  the  consequence  being  that  the  ac- 
tion of  the  ala  on  one  side,  and  the  chronic 
enlargement  of  the  mucous  membranes  of 
the  turbinated  bones  on  the  other  side,  ob- 
struct the  free  passage  of  air  through  Na- 
ture's channel,  the  nose,  thereby  producing 
mouth-breathing. 

Scrofula  a  Cause. — Again,  so-called  scrofu- 
lous children,  especially  among  the  poor  and 
ill-fed,  living  in  badly  ventilated  rooms  and 
surrounded  by  bad  air,  very  often  develop  a 
state  of  chronic  eczema  of  the  nostrils,  the 
discharges  from  which  becoming  inspissated 
form  crusts,  and  tend  more  or  less  to  block 
up  the  nostrils,  —  producing  in  many  cases 
a  state  of  things  which  forces  the  child  to 
breathe  through  its  mouth. 

Bleeding  from  the  Nose  also  a  Cause.  —  Many 
children  become  subject  to  chronic  headaches 
and  bleeding  from  the  nose.     The  blood  dry- 


42  MOUTH-BREATHING. 

ing  in  the  nasal  fossae  tends  to  block  up  the 
nostrils,  and  cause  the  child  to  breathe  ha- 
bitually through  its  mouth. 

At  a  more  adult  age,  also,  continual  colds 
in  the  head,  with  an  unusual  secretion  of 
mucus,  and  its  consequent  inspissation,  pro- 
duces obstructions  in  the  nasal  fossae ;  and 
mouth-breathing  is  the  result. 

Polypi  of  the  Nose.  —  Polypus  of  the  nose  is 
luckily  very  rare  among  children,  but  it  is 
comparatively  common  in  adult  life.  Growths 
like  polypi,  originating  as  they  do  from  the 
turbinated  bones  in  the  narrow  passages  of 
the  nose,  tend  to  block  up  the  nostrils,  —  in 
which  case  mouth-breathing  is  the  only  pos- 
sible way  by  which  air  can  reach  the  lungs. 

I  do  not  here  intend  to  go  through  the 
entire  list  of  the  diseases  which  may,  and  in 
most  cases  really  do,  tend  to  block  up  the 
nostrils  and  produce  mouth-breathing.  Their 
name  is  legion,  —  from  simple  congestion  to 
unquestionable  tumor,  etc.  My  object  is  to 
show  that  this  habit,  the  result  of  many 
causes,  occurs  more  or  less  in  childhood  and 
early  adult  life,  —  in  other  words,  in  those 
who  practically  have  their  life  before  them. 


FURTHER  CAUSES.  43 

The  Habit  of  Smoking.  — I  may  here  mention 
that  I  have  not  the  slightest  doubt  that  in 
the  case  of  a  person  with  a  perfectly  healthy 
heart,  healthy  digestion,  freedom  from  disease 
of  the  nose,  throat,  or  ears,  tobacco  does  of 
itself  little  or  no  harm ;  but  I  am  confident 
that  so  far  as  a  weak  heart  is  concerned, 
tobacco  must  of  necessity  —  as  a  direct  seda- 
tive and  depressant  —  do  a  great  deal  of 
harm ;  also  that  by  delaying  as  it  does  the 
action  of  the  gastric  juices,  it  must  of  ne- 
cessity, when  used  to  excess,  tend  to  produce 
a  state  of  chronic  dyspepsia,  —  and  dyspepsia 
is  very  often  a  direct  cause  of  throat  disease. 
And  I  emphatically  assert  that  in  all  cases 
in  which  we  find  a  tendency  to  weakness  of 
the  vocal  organs,  especially  of  the  mucous 
membranes, —  with  which  may  be  classed  a 
tendency  to  disease  of  the  nose,  —  tobacco  in 
all  forms  becomes  absolutely  injurious ;  and 
1  do  not  think  that  any  case  of  real  chronic 
disease  of  the  throat  can  be  cured  unless  the 
habit  be  entirely  abandoned. 

Intoxicating  Liquors.  — The  habit  of  drinking 
malt  liquors  and  undiluted  spirits  in  excess 
also  tends  to  produce  a  state  of  hypertrophy 


44  MOUTH-BREATHING. 

of  the  mucous  membrane  of  the  mouth  and 
throat.  Many  cases  of  mouth-breathing  no 
doubt  originate  in  habitual  and  excessive  use 
of  tobacco  and  stimulants.  It  stands  to  rea- 
son that  anything  which  will  bring  more 
blood  than  is  required  to  any  given  part 
must  tend  to  produce  enlargement  of  that 
part ;  and  hence  it  is  that  people  who  habitu- 
ally smoke  and  drink  are  always  more  or  less 
naouth-breathers,  especially  at  night,  when 
they  nearly  always  snore. 

Excessive  Use  of  the  Voice.  —  Excessive  USB 
of  the  voice,  as  in  the  case  of  clergymen,  also 
tends  to  produce  a  chronic  state  of  congestion 
of  the  throat,  and  of  breathing  through  the 
mouth. 

One  might  easily  enumerate  many  other 
causes  which  produce  this  pernicious  habit ; 
but  I'  think  I  have  mentioned  enough  to 
show  that  mouth-breathing  is  really  far  more 
common  than  it  is  generally  thought  to  be. 


CHAPTER  lY. 

EFFECTS. 

Now,  what  are  the  effects  of  this  mouth- 
breathing  ?  Does  it  really  do  any  great  harm  ? 
If  so,  in  what  way  ? 

As  I  have  already  demonstrated,  Nature 
has  supplied  us  with  an  organ  —  namely,  the 
nose — containing  passages  made  on  purpose 
to  carry  air  to  the  lungs ;  and  if  from  any 
cause  the  air  required  for  the  maintenance 
of  life  cannot  be  made  to  pass  through  these 
passages,  mouth-breathing  is  the  result,  — 
the  effects  of  which,  as  I  have  already  shown 
and  shall  now  proceed  still  further  to  show, 
are  in  many  instances  most  disastrous. 

General  Weakness  is  caused  by  Mouth-breath- 
ing. —  In  the  first  place,  young  children 
addicted  to  the  habit  of  mouth-breathing  are 
never  so  healthy  or  so  strong  as  those  who 
breathe  through  the  natural  channels.     They 


46  MOUTH-BREATHING. 

are  nearly  always  puny,  pale,  and  bloodless, 
their  chests  contracted,  pigeon-breasted,  and 
in  many  other  respects  undeveloped. 

False  Croup.  —  They  are  more  or  less  liable 
to  chronic  disease  of  the  larynx,  —  taking  the 
form  of  laryngismus  stridulus^  or  false  croup ; 
also  to  disease  of  the  lungs.  There  are  few 
medical  men  in  general  practice  who  do  not 
know  what  it  is  to  be  called  up  in  the  middle 
of  the  night,  or  in  the  early  morning,  to  see 
a  child  suffering  from  this  form  of  croup,  — 
in  most  cases  caused  by  stoppage  of  the 
nose,  and  mouth-breathing. 

Convulsions.  —  Convulsions  in  children  are 
also  often  developed  from  this  habit.  How 
can  a  child,  whose  natural  breathing-passage 
is  closed,  —  the  back  of  whose  throat  is  more 
or  less  blocked  up,  —  sleep  with  any  degree 
of  comfort  ?  In  such  a  condition  its  sleep 
is  always  more  or  less  troubled,  and  it  often 
wakes  up  gasping  for  breath,  —  an  attack  of 
convulsions  being  the  result.  No  child  can 
grow  and  become  properly  developed  whose 
rest  is  disturbed  in  this  way.  It  is  bad 
enough  as  age  creeps  on,  when  the  cares  and 
anxieties  of  life  weigh  heavily  on  our  shoul- 


EFFECTS.  47 

ders,  to  find  our  natural  sleep  a  thing  of  the 
past;  but  in  youth  how  disastrous  must  it 
be  to  future  healthy  growth  to  be  robbed  of 
sweet  and  refreshing  sleep !  There  is  no 
doubt  that  such  children  are  in  many  cases 
the  first  to  succumb  to  any  serious  illness  or 
disease,  simply  owing  to  the  loss  of  nervous 
power  which  results  from  want  of  proper 
sleep. 

Chronic  Bronchitis,  Asthma,  and  "Winter 
Cough.  —  Chronic  bronchitis  and  asthma  are 
too  often  developed  in  those  wha  are  obliged 
from  one  cause  or  another  to  breathe  more 
or  less  through  their  mouth,  especially  dur- 
ing sleep.  Most  cases  of  winter  cough  and 
bronchitis  among  elderly  people  have  their 
origin  in  this  habit. 

Epilepsy.  —  Many  cases  of  epilepsy  are  no 
doubt  to  some  extent  brought  about  by  mouth- 
breathing. 

To  sum  the  matter  up,  I  consider  that 
mouth-breathing  is  the  cause,  in  varying  de- 
gree, of  most  of  the  physical  troubles  to 
which  civilized  mankind  is  subject. 


CHAPTER  Y. 

TREATMENT. 

Can  anything  be  done  ?  —  Seeing  the  dan- 
gerous results  arising  from  mouth-breathing 
to  which  children  and  adults  are  liable,  the 
next  thing  to  be  considered  is,  Can  anything 
be  done  to  ward  off  or  modify  those  results, 
especially  in  the  young  whose  life  is  all  be- 
fore them  ? 

If  taken  in  time,  Yes.  —  I  say  that  in  the 
case  of  those  who  are  wise  and  have  the 
common-sense  to  apply  to  medical  men  who 
understand  these  several  diseases,  not  only 
can  something  be  done,  but,  if  the  child  be 
brought  early  enough,  perfect  cure  can  in 
most  cases  be  effected. 

If  neglected,  No.  —  On  the  other  hand,  if 
these  cases  be  left  to  Nature,  unaided  by  a 
surgical  science  which  every  day  grows  larger 
and   more  precise,  little  or  nothing  can  be 


TREATMENT.  49 

done  to  save  the  child  or  the  adult  from 
severe  suffering.  Not  only  must  these  per- 
sons be  in  a  continual  state  of  discomfort, 
owing  to  the  closure  of  Nature's  air-passage, 
but  the  disease  of  the  throat  must  become 
day  by  day  more  accentuated. 

Deafness  results  from  Neglect  of  Treatment. 
Moreover,  the  inflammatory  action,  situated 
as  it  is  in  the  nose  and  naso-pharynx,  tends 
of  necessity  to  extend  upwards  through  the 
orifices  of  the  eustachian  tubes,  and  produce 
more  or  less  in  every  case  disease  of  the 
middle  ear  and  deafness.  Hence  it  is,  that, 
of  any  fifty  persons  picked  out  haphazard, 
more  than  thirty  will  be  found  to  be  the 
subjects  of  disease  in  one  or  other  of  these 
organs.  It  is  a  most  uncommon  thing  to  find 
any  one  at  forty  years  of  age  who  has  not 
something  the  matter  with  one  or  the  other 
of  these  parts.  Does  it  not  then  behoove  us 
to  do  all  in  our  power  to  have  patients  placed 
under  proper  medical  care  before  the  disease 
has  produced  such  effects  as  to  be  almost 
incurable  ?  Ought  we  not  to  try  our  best  to 
effect  a  cure  before  the  disease  has  reached 
this  later  stage?     Nearly  all  children,  as  I 

4 


60  MOUTH-BREATHING. 

have  said,  if  brought  early  enough,  can  be 
more  or  less  completely  cured,  —  so  that  in- 
stead of  growing  up  to  be  stunted,  anaemic, 
unhealthy,  and  narrow-chested  men  and  wo- 
men, they  will  be  developed  into  such  whole- 
some manhood  and  womanhood  as  to  be  the 
pride  and  glory  of  the  nation.  It  really  be- 
comes of  national  import  to  produce  a  race 
of  people  equal  to  all  emergencies  and  able 
to  battle  with  the  difficulties  and  perform 
the  duties  of  life,  and  also  able,  by  their 
strength  both  of  body  and  mind,  to  promote 
the  welfare  of  the  country  to  which  they 
belong. 

Let  me  repeat  with  emphasis  that  children, 
if  brought  early  enough,  can  in  most  cases  be 
easily  cured. 

Removal  of  Nasal  Obstruction.  —  The  first 
thing,  of  course,  is  to  reopen  Nature's  door- 
way when  we  find  it  closed,  and  by  enabling 
the  child  once  more  to  breathe  through  proper 
channels,  insure  that  the  air  which  reaches 
its  lungs  shall  be  warmed  and  chemically 
acted  upon  by  Nature's  organs.  Should 
growths,  in  the  form  of  enlargements  or 
adenoids,    fill    the    naso-pharynx,    and    thus 


TREATMENT.  51 

block  up  the  posterior  nares,  they  must  at 
once  be  removed ;  and  I  myself  prefer  that 
kind  of  operation  which,  while  doing  all  that 
is  requisite,  leaves  the  various  parts  practi- 
cally as  they  should  be  in  Nature. 

Excision  of  Enlarged  Tonsils.  —  Should  the 
tonsils  be  enlarged  and  hypertrophic,  they 
should  be  thoroughly  removed ;  if  they  are 
left,  I  seldom  find  that  the  child  is  able  to 
breathe  through  the  proper  channel.  Al- 
though I  am  aware  that  many  specialists  are 
in  the  habit  of  removing  the  post-nasal 
growths  and  enlarged  tonsils  at  one  and  the 
same  time,  I  myself  deprecate  this  mode  of 
treatment ;  for  one  never  knows  how  much 
inflammatory  action  may  ensue  from  the 
removal  of  these  growths ;  and  if  much  in- 
flammatory action  does  ensue,  it  stands  to 
reason  that  the  tonsils,  being  again  supplied 
with  a  superabundant  amount  of  blood,  must 
of  necessity  begin  to  enlarge  again.  I  there- 
fore remove  the  post-nasal  growths  first,— 
sometimes  with  and  sometimes  without  anags- 
thetics,  according  as  the  child  will  or  will 
not  allow  me  to  have  full  control  over  it ; 
and  after  a  few  days,  —  say  a  week,  —  when 


52  MOUTH-BREATHING. 

everything  has  resumed  its  natural  and  quiet 
course,  I  proceed  to  remove  the  tonsils. 

After-treatment.  —  After  the  growths  and 
tonsils  have  been  removed,  the  next  thing  to 
do  is  to  find  out  from  the  persons  in  charge 
of  the  child  to  what  extent  it  now  breathes 
through  its  nose  ;  and  if  an  obstruction  still 
remains,  the  nose  should  be  thoroughly  ex- 
amined. Hypertrophies  should  be  lessened, 
enlargements  reduced,  and  spurs  and  enchon- 
dromas  removed ;  for  it  is  only  when  the 
child  can  breathe  again  through  Nature's 
channels  that  I  am  satisfied. 

Prevention  of  further  Mouth-breathing.  —  In 
most  of  these  cases  in  which  the  child  has 
acquired  a  confirmed  habit  of  mouth-breath- 
ing, in  order  to  educate  it  to  breathe  through 


its  nose  again  it  is  my  custom  to  proceed  by 
the  application  of  a  four-tailed  bandage  placed 
under  the  chin  (after  the  manner  of  treating 


TREATMENT.  53 

a  fractured  jaw),  thereby  causing  the  mouth 
to  be  closed  not  only  by  day,  but  by  night  as 
well,  for  several  weeks ;  and  my  experience  is 
that  after  removing  all  obstacles  from  the  nose, 
naso-pharynx,  and  pharynx,  it  is  possible  to 
educate  young  children  at  least  to  breathe 
again  more  or  less  completely  through  the 
nostrils.  I  am  sorry  to  say  that  the  older  a 
confirmed  mouth-breather  is,  the  more  dif- 
ficult it  appears  to  be  to  educate  him  to 
breathe  again  through  Nature's  channels, 
even  though  obstructions  have  been  removed. 
I  find  that  in  many  cases  of  patients  who 
are  forty  years  of  age  and  upwards,  it  is  al- 
most impossible  to  do  so.  I  think  the  rea- 
son for  it  is  that  so  many  elderly  persons  are 
foolish  enough  to  refuse  to  undergo  any  sys- 
tem of  treatment  which  entails  upon  them 
much  inconvenience.  I  have  often  to  tell 
patients  that  it  is  useless  for  them  to  un- 
dergo any  further  treatment  if  they  will  not 
persistently  follow  my  instructions,  and  do 
all  they  possibly  can  to  breathe  through  the 
nose. 

Deafness.  —  I    have   never    yet    treated    a 
deaf  person  who  did  not   snore,  —  in  other 


54  MOUTH-BREATHING. 

words,  who  did  not  breathe  through  the 
mouth  when  asleep ;  and  I  believe  that 
many  cases  of  so-called  incurable  deafness 
might  be  more  or  less  cured  if  the  patients 
would  perseveringly  and  steadily  follow  up 
the  practice  of  keeping  the  mouth  shut  by 
night  and  by  day.  Some  few  cases  of  deaf- 
ness are  no  doubt  caused  by. injury,  —  such 
as  a  noise  from  a  cannon  or  a  blow  on  the 
ear,  —  in  which  mouth-breathing  would  not 
of  necessity  be  induced ;  but  these  cases  are, 
in  my  experience,  rare.  In  all  cases  of  idio- 
pathic and  chronic  disease  of  the  middle  ear, 
sufferers,  so  far  as  I  have  observed,  breathe 
through  the  mouth,  especially  at  night-time, 
— thus  keeping  up  a  state  of  chronic  conges- 
tion of  the  back  of  the  throat,  naso-pharynx, 
nose,  and  eustachian  tubes,  which  it  is  im- 
possible to  cure,  unless  the  habit  itself  which 
is  the  cause  of  all  the  trouble  can  be  effectu- 
ally broken  up. 

My  practice  in  the  treatment  of  these 
diseases  is  to  do  only  so  much  as  (and  no 
more  than)  will  produce  the  effect  required ; 
namely,  to  cause  a  free  passage  through  the 
nose  and  naso-pharynx.     I  therefore  depre- 


TREATMENT.  65 

cate  all  heroic  treatment  of  the  nasal  fossae, 
etc.  It  cannot  be  good  surgery  to  remove 
a  turbinated  bone  which  Nature  has  placed 
there  to  fulfil  her  useful  purposes.  Once 
remove  a  part,  especially  a  bone,  and  the 
organ  from  which  the  removal  takes  place 
can  never  be  the  same  as  it  would  have  been 
in  Nature.  I  therefore  seldom  remove  these 
bones ;  but  enchondromas  and  spurs  must  be 
removed,  as  they  are  unnatural  growths.  I 
lessen  the  enlargement  of  the  turbinated  bones 
by  quiet  and  continuous  treatment.  This 
treatment  no  doubt  requires  more  time; 
but  the  ultimate  result  is,  in  my  opinion, 
better,  and  tends  to  leave  the  nasal  fossas 
more  nearly  as  they  should  be  found  in 
health.  For  the  chronic  thickening  of  the 
mucous  membrane  of  the  pharynx  such  rem- 
edies are  used  as  also  tend  gradually  to 
lessen  its  size ;  and  although  the  treatment 
is  rather  prolonged,  the  result  in  most  cases 
is  very  satisfactory. 

It  is  beyond  the  scope  of  this  little  work 
to  enter  into  all  the  cases  and  discuss  the 
treatments  of  the  many  and  various  diseases 
of  these  parts  of  the  body.     I  simply  wish, 


56  MOUTH-BEEATHING. 

as  I  said  before,  to  impress  upon  all  those 
interested,  not  only  the  importance  of  under- 
standing the  serious  danger,  to  child  or  adult, 
of  persistently  breathing  through  the  mouth, 
but  also  to  point  out  how  easily  and  effectu- 
ally the  different  causes  can  be  removed  and 
in  many  cases  the  effects  cured. 

Many  mothers  have  brought  their  children 
to  me  who  wh-en  asked,  "  Does  your  child 
snore  at  night  ? "  have  replied,  "  Oh,  yes,  sir ; 
we  have  often  laughed  at  the  child,  and  said 
it  snored  like  an  old  man."  They  little  knew 
the  injury  they  were  doing  to  that  child  by 
allowing  it  to  develop  the  habit  of  mouth- 
breathing  ;  and  many,  after  a  full  explana- 
tion of  the  causes  and  the  effects  of  this  habit, 
have  thanked  me,  and  said :  "  Why  was  I 
not  told  this  before  ?  If  I  had  only  known, 
I  would  have  brought  my  child  for  treatment 
sooner,  and  then,  no  doubt,  the  cure  would 
have  been  more  Complete." 

This  subject  is  to  my  mind  of  the  highest 
importance ;  for  I  am  sure  that  there  are 
many  now  practically  ruined  for  life,  so  far 
as  their  comfort  and  health  are  concerned, 
who  had  they  been  taken  in  hand  at  an  early 


TREATMENT.  57 

stage  and  properly  treated  would  now  be  in 
a  state  of  perfect  comfort  and  health. 

Discharges  from  the  Ear  very  dangerous.  —  I 
may  here  mention  that  all  discharges  from 
the  ear  should  have  early  and  proper  treat- 
ment. Nothing  is  more  dangerous  than  to 
allow  a  child  to  have  a  discharge  from  the 
ear.  It  means  that  sooner  or  later  the  bones 
of  the  middle  ear  will  become  necrosed,  or 
dead,  and  that  the  child  will  be  in  hourly 
danger  of  dying  from  inflammation  of  the 
brain.  Therefore,  never  allow  a  child  suffer- 
ing from  discharge  at  the  ear  to  be  left  to  Na- 
ture alone,  but  have  the  ear  properly  treated 
and  the  disease  cured  as  soon  as  possible. 


APPENDIX. 

I  FEEL  that  I  cannot  bring  this  little  work  to 
a  conclusion  without  a  few  remarks  upon  a 
disease  the  effects  of  which  are  even  more 
disastrous  than  those  to  which  the  book 
specially  refers.  I  allude  to  ophthalmia  in 
new-born  children. 

The  Victims  of  Ophthalmia  easily  cured  in  the 
first  stage.  —  It  is  sad  indeed  to  think  that  in 
this  country  alone  hundreds  and  thousands 
of  men,  women,  and  children,  otherwise  in 
good  health,  are  many  of  them  totally,  and 
the  others  more  or  less,  blind  from  this  dis- 
ease,—  a  disease  which,  if  taken  in  its  first 
stage,  is  so  easy  of  cure  that  a  few  hours' 
proper  treatment  would  in  most  cases  effect 
it ;  but  which  if  left  to  itself,  unaided  by 
proper  treatment,  is  one  of  the  most  difficult 
diseases  to  deal  withj  and  most  disastrous 
to  the  patient. 


APPENDIX.  59 

The  Disease  does  not  appear  immediately  after 
Birth.  —  It  is  unfortunate,  in  one  sense,  that 
the  victims  of  this  disease  always  appear, 
when  born,  to  be  in  a  state  of  perfect  health. 
Were  these  children  born  with  the  disease 
already  upon  them,  treatment  would  no 
doubt  be  more  frequently  applied.  But  the 
disease  never  shows  itself  until  the  child  is 
from  three  days  to  a  week  old^  —  three  days 
being  usually  the  time. 

The  so-called  Midwife.  —  Connected  as  I  am 
with  an  infirmary  which  treats  diseases  of 
the  eye,  ear,  throat,  and  nose,  I  have  great 
opportunities  for  seeing  and  judging  of  the 
disastrous  effects  of  this  disease ;  and  I  have 
noticed  that  in  nearly  all  cases  the  mothers 
of  the  children  brought  for  treatment  (un- 
happily too  far  gone  to  effect  a  proper 
cure)  have  been  attended  by  the  so-called 
midwife. 

How  the  Child  is  usually  treated.  — The  child, 
say  at  three  days  old,  has  what  these  mid- 
wives  call,  and  so  tell  the  mother,  a  "  slight 
cold  in  the  eyes."  What  is  the  rule  ?  The 
rule  is  to  bathe  the  eyes  with  a  little  milk 
and  water,  or  milk  from  the  mother's  breast, 


60  OPHTHALMIA  NEONATORUM. 

or  cold  tea,  and  nothing  more ;  while  in  many 
cases  the  eyes  are  left  severely  alone. 

The  often  Fatal  Result.  —  After  two  or  three 
weeks,  on  the  departure  of  the  midwife,  the 
mother  begins  to  get  about  again,  and  having 
no  one  to  help  her,  thinks  and  acts  for  her- 
self. Not  being  satisfied  with  the  state  of 
her  baby's  eyes,  she  at  last,  after  many  weeks' 
delay  (sometimes  as  many  as  six  or  eig]\t 
weeks),  takes  the  child  to  some  qualified 
practitioner;  and  the  result,  on  examination 
of  the  eyes,  is  that  she  is  told  that  the  eye- 
sight of  her  child  is  gone. 

These  cases,  as  I  have  mentioned  before,  if 
only  properly  recognized  and  treated  in  the 
first  stage,  can  be  cured  in  a  few  hours,  or  at 
the  most  in  a  few  days. 

A  proper  Certificate  of  Qualification  for  the 
Practice  of  a  Midwife  should  in  all  cases  be 
demanded.  —  When  one  comes  to  think  that 
thousands  of  children  every  year  are  allowed 
to  go  blind,  or  to  lose  so  much  of  their  sight 
that  practically  and  to  all  intents  and  pur- 
poses, so  far  as  gaining  a  livelihood  is  con- 
cerned, they  are  blind,  I  say  it  is  a  disgrace 
to  a  civilized  country  to  allow  this  state  of 


APPENDIX.  61 

things  to  go  on.  In  my  opinion,  no  woman 
should  be  allowed  under  a  penaltjj  and  a 
heavy  one  too,  to  attend  any  one  as  a  mid- 
wife until  she  has  passed  an  examination 
and  received  a  certificate  to  the  effect  that 
she  is  a  fit  and  proper  person  to  attend  such 
cases,  and  to  understand  and  recognize  this 
disease  in  its  first  stage. 

The  State  should  interfere.  —  When  one 
comes  to  think  that  hundreds  and  thousands 
of  our  fellow-creatures  are  doomed  to  a  life  of 
misery  and  blindness,  totally  unable  to  gain 
their  own  living  or  even  to  help  themselves, 
and  that  this  has  been  brought  on  simply 
through  the  ignorance  and  incapacity  of  those 
in  charge  of  them  during  the  first  weeks  of 
their  existence,  —  one  feels  that  it  is  time 
that  the  government  should  be  petitioned  to 
bring  forward  a  bill  which  would  make  it  a 
misdemeanor  to  practise  in  this  line  without 
a  proper  certificate. 

Blindness  a  State  question.  —  Every  blind 
person  naturally  becomes  a  burden  upon  his 
or  her  family,  or  a  drag  upon  the  rate-payers' 
pockets.  If  one  should  go  over  our  blind 
asylums,   and   analyze   the  cases  there,   one 


62      OPHTHALMIA  NEONATOEUM. 

would  find  that  nearly  four  fifths  of  the  in- 
mates are  blind  through  this  disease. 

It  is  useless  to  write  pamphlets,  print  in- 
structions, and  throw  them  broadcast  among 
a  population  four  fifths  of  whom  never  take 
the  trouble  to  read  them.  It  is  useless  to 
nail  these  instructions  even  upon  the  church- 
doors,  for  the  very  people  who  ought  to  read 
them  seldom  or  never  go  to  church.  Nothing 
will  ever  be  done,  in  this  country  at  any  rate, 
until  the  government  steps  in,  and,  treating 
all  as  ignorant  children  unable  to  take  care 
of  themselves,  passes  a  measure  making  it 
a  misdemeanor  for  any  one  to  practise  as  a 
midwife  without  a  proper  qualification. 

How  they  manage  in  France  and  Germany.  — 
I  believe  that  in  Germany,  and  also  in  France, 
it  is  the  rule  in  the  maternity  hospitals  to 
have  every  child  treated  for  this  disease  even 
before  the  disease  appears  ;  and  the  conse- 
quence is  that  one  hardly  ever  hears  of  a 
case  of  ophthalmia  of  new-born  children 
in  those  countries,  —  at  any  rate,  in  those 
institutions. 

Medical  men,  it  is  true,  understand  the 
jomplaint,  and  how   to   treat   it.     But  it  is 


APPENDIX.  63 

among  the  poor,  who  with  blind  infatuation 
refuse  to  avail  themselves  of  the  benefits  ac- 
corded to  them  by  the  State  in  the  form  of 
the  parish  doctor,  that  people  are  found  who 
in  their  silly  and  idiotic  independence  employ 
a  woman  more  ignorant  than  themselves. 

I  am  sure  that  nothing  will  ever  be  done 
to  lessen  the  evils  of  this  disease  until  a 
paternal  government  steps  in,  and  by  legis- 
lation makes  such  a  state  of  things  next  to 
impossible. 


64  OPHTHALMIA  NEONATORUM. 


THE  PREYENTION^  AND  TREATMENT  OF 
THE  OPHTHALMIA  OF  NEW-BORN 
INFANTS. 

BY   SWAN  M.   BURNETT,   M.  D.,  PH.D. 

Pkofessor  of  Ophthalmology  and  Otology  in  the 
University  of  Geokgetown  ;  Ophthalmic  and  Au- 
KAL  Surgeon  to  the  Garfield,  the  Providence,  and 
THE  Children's  Hospitals  ;  and  Director  of  the 
Eye  aind  Ear  Clinic  of  the  Emergency  Hospital 
of  Washington,  D.  C.i 

According  to  the  census  of  1880,  there  are 
about  fifty  thousand  blind  persons  in  the 
United  States.  Of  these  at  least  fifteen 
thousand  have  become  so  from  a  kind  of  in- 
flammation that  is  likely  to  attack  the  eyes  of 
a  new-born  infant.  It  is  not  claiming  more 
than  statistics  justify  to  assert  that  not  one 
of  these  fifteen  thousand  persons  would  have 
become  blind  had  the  proper  measures  been 
instituted    at    the    right    season.      In    those 

1  This  article  is  the  substance  of  a  lecture  delivered 
before  the  Training  School  for  Nurses  at  the  Garfield  Hos- 
pital, afterwards  printed  in  "  The  Trained  Nurse  "  for  Jan- 
uary, 1893;  and  of  an  "Open  Letter"  published  in  The 
Century  Magazine  for  December,  1892. 


APPENDIX.  65 

large  hospitals  where  the  preventive  meas- 
ures first  put  in  practice  by  Professor  Crede, 
of  Leipsic,  are  in  force,  the  disease  is  prac- 
tically stamped  out.  But  unfortunately  all 
infants  are  not  born  in  a  well-regulated  hos- 
pital, and  a  very  large  number  make  their 
advent  into  the  world  under  the  superinten- 
dence of  persons  wholly  ignorant  of  the 
gravity  of  this  disease,  and  with  no  knowl- 
edge of  the  proper  method  of  treating  it 
after  it  has  once  been  established. 

The  minimum  cost  of  sustenance  of  a  sin- 
gle person  in  our  best  and  most  economically 
managed  institutions  for  the  blind  is  about 
il32  a  year ;  the  cost  of  the  "  keep  "  of  these 
fifteen  thousand  blind  persons  is,  therefore, 
nearly  two  million  dollars  annually.  But 
these  men  and  women,  if  they  had  not  been 
blind,  would  have  been  contributors  instead  of 
an  expense  to  the  community,  and  their  net 
contribution  to  the  general  fund  can  be  taken 
as  at  least  one  dollar  a  day  on  the  average. 
Adding  this  to  the  cost  of  maintenance,  we 
have  the  total  loss  to  the  commonwealth  of 
seven  million  five  hundred  thousand  dollars 
each  year ;  and  this  takes  no  account  of  those 

5 


66      OPHTHALMIA  NEONATORUM. 

made  partially  blind  by  the  disease.^  And 
then,  of  course,  there  is  the  humanitarian 
point  of  view,  which  after  all  is  the  chief 
one;  for  what  calamity  can  be  more  awful 
than  for  a  human  being  to  be  launched  into 
life  handicapped,  with  the  loss  of  one  of  its 
most  important  senses !  Life  offers  us  none 
too  much  at  best,  but  that  any  one  should 
have  to  grope  through  it  in  darkness  to  the 
gloom  of  the  grave,  and  that  because  of  the 
neglect  of  others,  places  a  responsibility  some- 
where which  should  be  looked  into.  And  the 
pity  as  well  as  the  crime  of  it  is  that  there  is 
no  need  that  it  should  be  so.  Ophthalmia 
Neonatorum  is  essentially  a  preventable  dis- 
ease. If  the  proper  precautions  are  taken 
there  should  not  be  a  single  eye  lost,  where 
now  there  are  thousands  ;  and  that  these  eyes 
are  not  saved  is  due  to  the  ignorance  of  those 
whose  duty  it  is  to  care  for  the  infant  during 
the  first  hours  and  days  of  its  existence.  Fur- 
thermore, this  ignorance,  I  am  ashamed  to  say, 
is  not  confined  to  the  ordinary  midwife,  but 
is  to  be  found  among  members  of  the  medical 

1  See  article  by  the  author,  "  Blindness  from  Babies'  Sore 
Eyes,"  in  New  York  "  New  Record/'  Feb.  22,  1890. 


APPENDIX.  '  67 

profession  who  hold  good  positions  in  the 
community,  and  should  have  had  the  oppor- 
tunity of  being  well-instructed.  We  could 
indeed,  with  perfect  justice,  go  back  even 
further,  and  lay  the  responsibility  upon  our 
teachers ;  for,  with  only  a  few  exceptions,  our 
professors  of  obstetrics  neither  in  their  lec- 
tures nor  in  their  text-books  alluded  in  any 
way  to  the  care  or  even  inspection  of  the 
eyes  of  the  new-born  infant.  The  golden  op- 
portunity for  attacking  the -disease  is  at  the 
hour  and  moment  even  of  the  birth  of  the 
child  ;  and  if  this  is  not  seized,  the  enemy  has 
a  great  and  constantly  increasing  advantage 
over  us. 

The  infant  brings  the  seeds  of  the  disease 
already  implanted  in  its  eyes  on  its  entrance 
into  the  world.  It  is  infected  in  its  passage 
through  the  vagina  of  the  mother  by  the 
germs  that  exist  in  the  secretions.  The  viru- 
lence of  these  secretions  varies  from  the  most 
intense  to  that  so  mild  as  to  cause  only  a 
short  and  temporary  irritation.  But  this 
latter  is  very  rare,  and  where  we  have  the 
disease  announcing  itself  within  the  first 
forty-eight  hours  after  birth,  it  is  always  of 


68  OPHTHALMIA  NEONATOEUM. 

sufficient  intensity  to  endanger  the  integrity 
of  the  eye. 

To  Professor  Crede,  of  Leipsic,  belongs  the 
honor  of  instituting  the  successful  and  com- 
plete prophylaxis  of  oplitJialmia  neonatorum. 
His  method  is  as  simple  as  it  is  effective. 
As  soon  as  the  child's  head  is  born,  the  eye- 
lids are  carefully  cleansed  and  opened,  and 
from  a  glass  rod  some  four  per  cent  of  nitrate 
of  silver  solution  is  dropped  into  the  eye. 
This  one  application  is  sufficient  to  destroy 
whatever  germs  may  have  gotten  in ;  and  un- 
less some  are  introduced  later,  the  eye  will 
be  free  from  infection.  This  may  appear  to 
be  harsh  treatment  of  such  delicate  tissues, 
but  it  is  seldom  that  there  is  any  excessive 
reaction.  Where  the  suspicion  of  infection 
is  scant,  simple  cleansing  with  a  saturated 
boric-acid  solution  will  usually  be  sufficient, 
with  a  careful  watching  of  the  eye  afterwards. 
But  the  condition  of  the  eye  in  every  case 
should  be  noted  every  time  the  infant  is 
dressed ;  and  as  soon  as  any  redness  and 
swelling  of  the  lids  are  manifest,  a  competent 
physician  should  be  called,  if  there  is  not  one 
in  attendance. 


APPENDIX.  69 

In  some  countries  of  Europe  the  State  has 
taken  the  matter  in  hand,  and  has  made  it 
compulsory  on  the  attendant  to  report  at  once 
to  the  proper  medical  authorities  all  infants 
whose  eyes  show  signs  of  being  affected.  In 
spite  of  earnest  petitions,  Great  Britain  has 
refused  to  take  any  official  notice  of  it.  In 
this  country  three  States  at  least  have  taken 
definite  action  in  the  matter.  '  Two  years  ago 
the  legislature  of  New  York  passed  an  ordi- 
nance making  it  compulsory  on  the  attendant 
to  report  all  cases  at  once  to  the  sanitary  au- 
thorities ;  and  Maine  and  Rhode  Island  have 
within  the  year  followed  her  worthy  example. 
Several  other  States  have,  I  believe,  the  mat- 
ter under  consideration.  All  this  is  good  and 
necessary,  and  should  be  made  universal ;  but 
of  what  advantage  are  statutes  if  the  people 
are  unaware  of  the  danger  ?  In  some  way  or 
ways  we  must  let  them  into  the  knowledge  of 
what  babies'  sore  eyes  may  mean. 

The  time  to  combat  successfully  the  disease 
when  once  it  is  established  is  at  the  begin- 
ning. The  characteristics  of  the  affection 
are  great  swelling  and  redness  of  the  lids 
and   a  profuse  discharge   of   matter.     Every 


70  OPHTHALMIA  NEONATORUM. 

time  the  lids  are  opened,  there  is  a  gush  of 
purulent  matter  as  from  a  freshly  opened 
abscess.  It  is  astonishing  how  much  pus 
can  be  secreted  by  so  limited  an  extent  of 
surface. 

In  the  event  that  any  of  you  should  be 
called  upon  to  attend  any  such  case  away 
from  competent  medical  advice,  I  would  say 
that  the  proper  treatment  consists  first  in 
keeping  the  eyes  as  clean  as  possible.  They 
should  be  cleansed  often,  —  as  frequently  as 
every  fifteen  minutes,  day  and  night,  when 
the  discharge  is  profuse. 

Eternal  vigilance  is  the  price  we  must  pay 
for  the  salvation  of  such  eyes.  This  cleans- 
ing can  be  done  by  opening  the  lids  as  widely 
as  possible,  and  irrigating  the  surface  with  an 
antiseptic  solution  squeezed  from  absorbent 
cotton.  When  the  lids  are  very  much  swollen 
and  the  infant  struggles,  this  is  not  easy ; 
but  then  the  lids  are  usually  everted  and 
the  conjunctiva  exposed,  which  renders  the 
cleansing  easier.  Three  times  a  day,  after 
such  a  cleansing,  a  drop  of  a  solution  of 
nitrate  of  silver  (two  or  three  grains  to  the 
ounce  of  water)  should  be  applied.     As  the 


APPENDIX.  71 

discharge  diminishes,  the  cleansing  can  be  re- 
peated at  gradually  increasing  intervals. 

But  by  all  means  the  most  important  con- 
sideration is  the  prevention;  and  this  can- 
not be  accomplished  unless  a  knowledge  of 
the  danger  of  the  disease  is  widely  dissemi- 
nated among  all  classes  of  people,  but  par- 
ticularly among  the  ignorant  and  poor,  where 
the  conditions  most  productive  of  the  disease 
do  most  abound.  As  I  have  said,  the  time 
for  the  successful  treatment  of  the  disease 
is  at  the  very  beginning.  If  the  dangers  are 
not  recognized,  there  is  always  a  tendency 
to  delay,  with  the  thought  that  it  is  "  only  a 
cold  in  the  eye,  and  if  a  little  breast  milk  is 
put  into  it  it  will  come  all  right  in  a  few 
days."  If  you  had  heard  this  story  as  often 
as  I  have,  as  told  to  me  by  the  mothers  who 
brought  their  babies  to  my  clinic  **  to  have 
the  scum  taken  from  their  eyes,"  and  then 
seen  the  look  of  anguish  in  their  faces  when 
I  told  them  (as  I  had  to)  that  their  little 
ones  could  never  see  again,  —  you  would  not 
wonder  at  the  earnestness  with  which  I  am 
urging  the  importance  of  the  subject  upon 
those  who  have  the  care  of  women  likely  to 


72      OPHTHALMIA  NEONATOEUM. 

become  mothers.  These  people  must  be 
reached  in  some  way  or  other;  but  if  our 
own  profession  and  the  mass  of  intelligent 
people  are  so  ignorant  of  or  indifferent  to 
the  matter,  how  can  we  expect  the  uneducated 
and  careless  to  know  or  heed  ?  And  yet,  for 
our  own  sakes  as  well  as  theirs,  the  knowl- 
edge must  be  got  to  them.  You  can  do  your 
part  by  insisting  upon  its  importance  wherever 
an  opportunity  offers.  Suffer  no  chance  to 
escape  of  diffusing  information  as  to  the  dan- 
ger of  neglected  babies'  sore  eyes.  Great  good 
can  be  done  by  our  charitable  organizations, 
and  particularly  those  which  have  to  do  with 
women.  In  each  of  the  institutions  or  socie- 
ties or  church  organizations,  or  association 
of  whatever  kind,  I  would  have  a  supply  of 
cards  reading  something  like  this :  — 

IMPORTANT  NOTICE. 

If  a  haby^s  eyes  RUN  with  matter  and  look 
RED  a  few  days  after  birth,  take  it  AT  once  to 
a  doctor.  Belay  is  dangerous,  and  ONE  eye 
or  BOTH  eyes  may  he  destroyed  if  not  treated 

IMMEDIATELY. 


APPENDIX,  73 

These  should  be  distributed  as  widely  as 
possible ;  and  the  bread  thus  cast  upon  the 
water  will  be  gathered,  not  many  days  hence, 
in  the  saving  of  many  eyes  which  would  other- 
wise have  been  shut  out  forever  from  the 
glorious  light  of  heaven. 


THE  END. 


Messrs.  Roberts  Brothers''  Publications. 

POWER  THROUGH  REPOSE. 

By  ANNIE   PAYSON   CALL. 

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THE  PILGRIMS  SCRIP; 


OR, 


WIT  AND  WISDOM  OF  GEORGE  MEREDITH. 

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It  has  taken  a  long  time  for  the  world  to  appreciate  George  Meredith, 
to  even  understand  him ;  but  to-day  the  recognition  of  him  has  come,  and 
there  is  no  question  but  that  he  will  be  fully  remembered  and  live  among 
the  romance  writers  of  the  last  half  of  the  present  century.  For  spiritual 
philosophy  and  golden  wisdom  of  life  "  The  Ordeal  of  Richard  Feveral " 
must  have  a  permanent  place  in  the  literary  world,  Mrs.  M.  R.  F.  Gil- 
man,  who  had  made  the  selections  to  be  found  in  this  volume,  fully  under- 
stands Mr.  George  Meredith's  worth,  and  it  is  in  the  hope  "of  gaining  for 
this  philosophical  novelist''  an  opportunity  of  being  better  appreciated 
that  these  selections  have  been  made.  — N.  Y.  Times. 

Steadily  the  American  reader  of  light  literature  is  beginning  to  recog- 
nize in  George  Meredith  the  greatest  living  writer  of  Enghsh  fiction,  —  a 
man  who  is  bound  by  none  of  the  conventional  rules  which  hamper  and 
close  in  the  general  novelist,  who  is  original  in  his  methods,  and  who  is 
apparently  utterly  careless  as  to  what  the  public  thinks  or  says  of  his  work 
or  of  himself.  He  works  by  no  set  rule  -,  one  cannot  believe  that  his 
books  are  planned.  They  are  begun,  and  they  go  on,  like  a  man's  life, 
and  often  stop  as  suddenly  and  unexpectedl3^  They  are  not  well  rounded 
and  complete;  no  man's  life  is.  But  they  are  like  Ufe.  Their  people  are 
real  people,  and  things  happen  in  them  as  they  happen  to  us.  They  are, 
besides,  full  of  meat.  They  make  us  think.  There  is  no  taint  of  mor- 
bidity or  moral  unhealthiness  in  them,  and  no  attempt  to  point  a  moral. 
The  reading  public  is  indebted  to  Roberts  Brothers  for  the  two  excel- 
lent editions  of  Meredith  which  have  been  brought  out  within  the  past 
year. 

This  house  has  also  just  brought  out  a  little  volume,  *'  The  Pilgrim's 
Scrip,"  made  up  of  choice  extracts  from  Meredith's  novels  and  poems, 
which  will  do  much  to  turn  attention  to  that  author.  It  is  compiled  by 
Mrs.  M.  R.  F.  Gilman,  whose  excellent  taste  and  keen  literary  judg- 
ment have  guided  her  unerringly  to  the  best  things,  and  have  enabled  her 
to  give  the  author  "in  little"  to  his  admirers,  and  to  furnish  those  who 
have  yet  to  make  acquaintance  with  his  writings  a  taste  that  will  grow  to 
an  appetite  for  a  feast.  —  Transcript. 


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THE  WHAT-TO-DO  CLUB. 

A   STORY   FOR   GIRLS. 

By  Helen  Campbell. 
i6mo.     Cloth.     Price  $1.50. 


•*  •  The  What-to-do  Club '  is  an  unpretending  story.  It  introduces  ns  to  Q 
dozen  or  more  village  girls  of  varying  ranks.  One  has  had  superior  opportuni* 
ties ;  another  exceptional  training ;  two  or  three  have  been  '  away  to  school ;  * 
8ome  are  farmers'  daughters ;  there  is  a  teacher,  two  or  three  poor  self -support- 
ers, —  in  fact,  about  such  an  assemblage  as  any  town  between  New  York  and 
Chicago  might  give  us.  But  while  there  is  a  large  enough  company  to  furnish  a 
delightful  coterie,  there  is  absolutely  no  social  life  among  them.  .  .  .  Town  acd 
country  need  more  improving,  enthusiastic  work  to  redeem  them  from  barrenness 
and  indolence.  Our  girls  need  a  chance  to  do  independent  work,  to  study  prac- 
tical business,  to  fill  their  minds  with  other  thoughts  than  the  petty  doings  of 
neighbors.  A  What-to-do  Club  is  one  step  toward  higher  village  life.  It  is  one 
step  toward  disinfecting  a  neighborhood  of  the  poisonous  gossip  which  floats  like 
a  pestilence  around  localities  which  ought  to  furnish  the  most  desirable  homes  in 
our  country."  —  The  Chautatiquan. 

" 'The  What-to-do  Club 'is  a  delightful  story  for  girls,  especially  for  New 
England  girls,  by  Helen  Campbell.  The  heroine  of  the  story  is  Sybil  Waite,  the 
beautiful,  resolute,  and  devoted  daughter  of  a  broken-down  but  highly  educated! 
Vermont  lawyer.  The  story  shows  how  much  it  is  possible  for  a  well-trained  and 
determined  young  woman  to  accomplish  when  she  sets  out  to  earn  her  own  living, 
or  help  others.  Sybil  begins  with  odd  jobs  of  carpentering,  and  becomes  an  artist 
in  woodwork.  She  is  first  jeered  at,  then  admired,  respected,  and  finally  loved 
by  a  worthy  man.  The  book  closes  pleasantly  with  John  claiming  Sybil  as  his 
own.  The  labors  of  Sybil  and  her  friends  and  of  the  New  Jersey  '  Busy  Bodies,' 
which  are  said  to  be  actual  facts,  ought  to  encourage  many  young  women  to  more 
successful  competition  in  the  battles  of  life."  —  Golden  Rtde. 

"  In  the  form  of  a  story,  this  book  suggests  ways  in  which  young  women 
may  make  money  at  home,  with  practical  directions  for  so  -doing.  Stories  with  a 
moral  are  not  usually  interesting,  but  this  one  is  an  exception  to  the  rule.  The 
narrative  is  lively^  the  incidents  probable  and  amusing,  the  characters  well-drawn, 
and  the  dialects  various  and  characteristic.  Mrs.  Campbell  is  a  natural  story- 
teller, and  has  the  gift  of  making  a  tale  interesting.  Even  the  recipes  for  pickles 
and  preserves,  evaporating  fruits,  raising  poultry,  and  keeping  bees,  are  made 
po^S  and.  itivested  with  a  certain  ideal  glamour,  and  we  are  thrilled  and  absorbed 
by  an  array  of  figures  of  receipts  and  expenditures,  equally  with  the  changeful 
incidents  of  flirtation,  courtship,  and  matrimony.  Fun  and  pathos,  sense  and 
sentiment,  are  mingled  throughout,  and  the  combination  has  resulted  in  one  ol 
the  brightest  stories  of  the  season."  —  Woman's  Jotirtial. 


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PRISONERS  OF  POVERTY. 

WOMEN  WAGE-WORKERS :   THEIR  TRADES  AND 
THEIR  LIVES. 

By   HELEN    CAMPBELL, 

AUTHOR    OF    "the    what- to-do    club,"    "  MRS.     HERNDOIn'S    INCOME,"    "  MISS 

melinda's  opportunity,"  etc. 
i6ino.     Cloth.    $1.00.     Paper,  50  cents. 


The  author  writes  earnestly  and  warmly,  but  without  prejudice,  and  her  volume 
is  an  eloquent  plea  for  the  amelioration  of  the  evils  with  which  she  deals.  In  the 
present  importance  into  which  the  labor  question  generally  has  loomed,  this  vol- 
ume is  a  timely  and  valuable  contribution  to  its  literature,  and  merits  wide  read- 
ing and  careful  thought.  —  Sciturday  Eveni7ig  Gazette. 

She  has  given  us  a  most  effective  picture  of  the  condition  of  New  York  working- 
women,  because  she  has  brought  to  the  study  of  the  subject  not  only  great  care 
but  uncommon  aptitude.  She  has  made  a  close  personal  investigation,  extending 
apparently  over  a  long  time  ;  she  has  had  the  penetration  to  search  many  queer 
and  dark  corners  which  are  not  often  thought  of  by  similar  explorers;  and  we 
suspect  that,  unlike  too  many  philanthropists,  she  has  the  faculty  of  winning  con- 
fidence and  extracting  the  truth.  She  is  sympathetic,  but  not  a  sentimentalist ; 
she  appreciates  exactness  in  facts  and  figures  ;  she  can  see  both  sides  of  a  ques- 
tion, and  she  has  abundant  common  sense.  —  New  York  Tribune. 

Helen  Campbell's  "  Prisoners  of  Poverty"  is  a  striking  example  of  the  trite 
phrase  that  "  truth  is  stranger  than  fiction."  It  is  a  series  of  pictures  of  the  lives 
of  women  wage-workers  in  New  York,  based  on  the  minutest  personal  inquiry  and 
observation.  No  work  of  fiction  has  ever  presented  more  startling  pictures,  and, 
indeed,  if  they  occurred  in  a  novel  would  at  once  be  stamped  as  a  figment  of  the 
brain.  .  .  .  Altogether,  Mrs.  Campbell's  book  is  a  notable  contribution  to  the  labor 
literature  of  the  day,  and  will  undoubtedly  enlist  sympathy  for  the  cause  of  the  op- 
pressed working-women  whose  stories  do  their  own  pleading.  —  Springfield  Union. 

It  is  good  to  see  a  new  book  by  Helen  Campbell.  She  has  written  several 
for  the  cause  of  working-women,  and  now  comes  her  latest  and  best  work,  called 
"  Prisoners  of  Poverty,"  on  women  wage-workers  and  their  lives.  It  is  compiled 
from  a  series  of  papers  written  for  the  Sunday  edition  of  a  New  York  paper.  The 
author  is  well  qualified  to  write  on  these  topics,  having  personally  investigated  the 
horrible  situation  of  a  vast  army  of  working-women  in  N  ew  York,  —  a  reflection  of 
the  same  conditions  that  exist  in  all  large  cities. 

It  is  glad  tidings  to  hear  that  at  last  a  voice  is  raised  for  the  woman  side  of  these 
great  labor  questions  that  are  seething  below  the  surface  calm  of  society.  And  it 
is  well  that  one  so  eloquent  and  sympathetic  as  Helen  Campbell  has  spoken  in  be- 
half of  the  victims  and  against  the  horrors,  the  injustices,  and  the  crimes  that  have 
forced  them  into  conditions  of  living  —  if  it  can  be  called  living  —  that  are  worse  than 
death.  It  is  painful  to  read  of  these  terrors  that  exist  so  near  our  doors,  but  none 
the  less  necessary,  for  no  person  of  mind  or  heart  can  thrust  this  knowledge  aside. 
It  is  the  first  step  towards  a  solution  of  the  labor  complications,  some  of  which 
have  assumed  foul  shapes  and  colossal  proportions,  through  ignorance,  weakness, 
and  wickedness.  —  Hartford  Times. 


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price^  by  the  piiblishers., 

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